Provider Demographics
NPI:1770450462
Name:VILLARREAL, LAURA ZELDA (RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ZELDA
Last Name:VILLARREAL
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 GARZA ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6644
Mailing Address - Country:US
Mailing Address - Phone:956-289-9112
Mailing Address - Fax:
Practice Address - Street 1:2721 GARZA ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6644
Practice Address - Country:US
Practice Address - Phone:956-289-9112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT04134133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered